Sample/opqrst

[ForNever510]

Ok, this is probably a real "n00b" question for most of you, but unfortunately, in my classroom, it was mostly book work rather than practicing Assessments for the real thing.

With that being said my question would be, How would you obtain a "SAMPLE" History from a TRAUMA patient, when the problem really isn't a MEDICAL problem? I'm not sure i understand the concept behind it and how to ask questions to this type of patient. (ex. "S" - What signs and symptoms occured at the onset of your illness? Why do you obtain a SAMPLE history when you obviously know their injury is from a Significant MOI?

And do you use OPQRST questions to "Assess" their pain from the Significant MOI or for another reason?

I'm sort of confused, and i'm really trying to understand this so i can finally get a job!!!

Any help would be appreciated and if anyone could give me examples of questions they use to ask for SAMPLE and OPQRST in TRAUMA situations would be greatly appreciated to better help me understand!!


Thanks!

 

[medicdan]

The questions encompassed in SAMPLE and OPQRST aren't all questions you need to ask the patient, but answers you need to find. Using the example of a Trauma patient, asking "where does it hurt" encompasses "S", yet its still very important to find out if the patient has any allergies, is on any medications, any medical history, their last meal, and what happened before their trauma.

I'll ask you back, OP-- why are these things important for your assessment?

How about OPQRST? You don't need to ask the patient every question directly, but find out if they had pain before falling, or if anything makes it better or worse, whether it moves, how bad it is, etc.

Again, I'll ask you back, Why are these things important for your assessment?

Assessment is more then just asking the questions in order, it's about listening to the answers and acting accordingly. THink about what some various answers are, and how that would change your assessment or treatment.

 

[JPINFV]

Just because someone has a MOI from trauma doesn't mean that the signs and symptoms are going to be obvious. An assessment isn't just to determine what happened, but also the extent of damage because of what ever happened. Is there compartment syndrome occurring? Are there signs of significant internal bleeding? What medications are they on? Are there any medical conditions that could complicate treatment? Where is the pain? What positions make the pain better/worse? Sharp or dull pain? So on and so forth.

 

[CountryEMT-bGurl]

You can ALWAYS ask your SAMPLE to family members or close friends on scene if the pt. is unresponsive or not oriented enough!
For example; you roll up on a MVA. You see your pt. he has a large abrasion on his forehead with lots of blood and he is leaning his head on the steering wheel. He is very out of it. His wife is alert and oriented, you ask her SAMPLE questions about her husband. She tells you he takes insulin an has missed lunch today while answering your SAMPLE questions about him. Istead of going applying pressure an treating his head wound, you know now he also has another medical emergency which may have caused the crash!!!! ALWAYS try to obtain SAMPLE hx. if possible! It is very important.

 

[zmedic]

Also keep in mind this patient is going to the hospital, where in addition to their trauma they will also have to have their underlying medical problems addressed. So the 70 year old with a hip fracture will have to get their blood pressure meds, heart meds etc when in the hospital even though that doesn't directly have to do with their injury. Unless they are taking blood thinners and that's real important.

Especially when coming from nursing homes, if you don't get all the info when you are on scene it'll be much harder to get later on.

For patient's who are going to surgery, clearly their allergies and last time they ate will be important.

 

[medicdan]

OP, are you still here? What do you think the answers are to my questions? Do others want to answer?
What truly is the value of the answers to these questions?